Healthcare Provider Details

I. General information

NPI: 1952626350
Provider Name (Legal Business Name): JOHN DAVID CAHOY M.D./PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 04/22/2020
Certification Date: 04/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 BAKER AVENUE EXT SUITE 200
CONCORD MA
01742-2137
US

IV. Provider business mailing address

54 BAKER AVENUE EXT SUITE 200
CONCORD MA
01742-2137
US

V. Phone/Fax

Practice location:
  • Phone: 978-369-5391
  • Fax: 978-369-7661
Mailing address:
  • Phone: 978-369-5391
  • Fax: 978-369-7661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number266960
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number266960
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: